Is Tramadol part of your Narc count?

Nurses General Nursing

Published

Just wondering. I work a couple of LTCs and LTACs as agency. Some places have Ultram in their lock boxes and its part of the narc count. Others have it in the regular pill drawer. What is your facility practice, and do you know the rationale for locking it up? Is it a highly diverted pain med?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I've worked in multiple facilities over the past few years. None of them have included Tramadol (Ultram) as part of the narcotic counts. The Tramadol typically is kept in the regular drawers with the other routine medications.

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Specializes in MSP, Informatics.

we just switched to an automated med machine, and the PHA can set any med to verify quantity. He does this with all narcs of course, and other things that seem to evaporate. Previcid is prompted to count. And durring the flu season, all antibiotics and antivirals are set to prompt a count.

to him its inventory control, and if he uses it like that, there arn't any red flags.

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interesting how different things are run in different places. Maybe if a facility has had a hx of pain pills 'walking away' then they decide to enact the count for anything that may be a temptation.

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Specializes in LTC.

It is in our narc count also. Our pharmacy downsized and we had to switch to one under the same name but in a closer location a few months ago and with the new one they sent this med out as a non control and we had to make out new narc count sheets for them....my boss asked them about it and they said it was up to us.....we could do it either way...and since we've been counting it for x amt of years we just kept it this way. Before it was put with our narcs ..it was easy for them to come up missing and refills needed too soon...so thats probably how it got started where I work. But really ...if you think about it....in LTC its very easy for a nurse to divert meds.....huge patient loads given to one nurse at a time.....very easy to do for those that are into theft.

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Specializes in my patients.

I'm a RN at a post-op rehab facility (knees, hips, that kind of thing). Tramadol is not considered a Narc at our facility. Oxy & Fentanyl patches are the main/most popular ones we count daily.

How many times a day does your facility do a Narc count? Ours is once a day....

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Specializes in Med/Surg.

It isn't where I work (but then again, neither are the elixirs like Lortab and Tylenol 3, due to "not enough room in the PYXIS. They send it up in multi-dose bottles, I've been trying to get them to change that practice for years).

Anyway, back to the Tramadol.

While it isn't legally considered a controlled substance, it acts very similarly to codeine. People can and do get addicted to it, and stopping it suddenly causes withdrawal symptoms (and seizures). Google it and you'll find a bunch of info and postings on forums re: tramadol addiction. It's more common than you'd think.

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Specializes in Gerontological, cardiac, med-surg, peds.

It is not included in the narc count at my secondary employer.

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Specializes in Med Surg.

It's locked up and counted at each shift change where I am. I think I've given it maybe 3 times in the last month.

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Specializes in Medical.

We have pre-printed count books for schedule 8 (narcotics/drugs of addiction) and schedule 11 (non-narcotic/drugs of dependency) meds. Although tramadol's pre-printed in the schedule 11 book it isn't locked up, perhaps because we use it so rarely that a sudden drop in stock would be obvious.

After a drug-dependent former staff member stole a PCA key and syringe from a post-op patient (when confronted she said she was the anaesthetist and ceased the infusion on the chart!) we now include PCA keys in the count, which is done TDS at shift change with one person from each shift doing the count.

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Specializes in Geriatrics, Transplant, Education.

Nope, not counted at my facility. I have two patients on it right now, and it's right in with their routine meds.

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Specializes in Geriatrics, Home Health.
How many times a day does your facility do a Narc count? Ours is once a day....

Three times a day, at change of shift.

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We use an AccuDose where I work, and the meds kept in their are either the controlled substances (those ones will come up as a narc discrepency), emergency meds like Nitro (no count discrepencies, but you have to count how many are left when you take one out just to make sure we don't run out) and commonly given PRN meds like Senna and Phenergen. That we we don't have to wait for pharmacy to send the meds to us to deliver them tot he patients.

We don't have a "narc count." Narc discrepencies show up on the AccuDose screen.

Ultram is not in the AccuDose. That is sent from pharmacy and we keep it with a patient's other meds.

*~Naomi Grace~*

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